From the Guidelines
DHEA should only be considered for women with hormone-positive breast cancer who are symptomatic and not responding to conservative measures, after a thorough discussion of risks and benefits, as stated in the adapted recommendations by the American Society of Clinical Oncology 1. When considering the role of Dehydroepiandrosterone (DHEA) in women, it's essential to weigh the potential benefits against the risks, particularly in women with a history of cancer or those on endocrine therapy. The use of DHEA in women with symptoms of vaginal atrophy or other vaginal issues is not fully understood, and there is limited supportive data on its use in this population 1. Some potential benefits of DHEA for women include:
- Improving symptoms of vaginal atrophy, such as dryness
- Relieving dyspareunia (painful intercourse)
- Possibly improving bone density and reducing the risk of osteoporathy However, the risks and uncertainties associated with DHEA use, particularly in women with hormone-sensitive conditions, must be carefully considered. Women with current or a history of breast cancer who are on aromatase inhibitors and have not responded to previous treatment may be offered vaginal DHEA, but only after a thorough discussion of the potential risks and benefits 1. It's crucial to note that DHEA can convert to estrogen, which may exacerbate hormone-sensitive conditions like breast cancer, endometriosis, or uterine fibroids. In general, the use of DHEA in women should be approached with caution, and alternative treatments, such as vaginal moisturizers, lubricants, and low-dose vaginal estrogen, should be considered first 1.
From the FDA Drug Label
INDICATIONS: Temporarily supports the body to rebalance Adrenal and DHEA output. Symptoms of imbalanced Adrenal and DHEA may include: low energy, depression, anxiety, dry eyes, skin, and hair, loss of head hair. The role of DHEA in women is to temporarily support the body in rebalancing Adrenal and DHEA output, which may help alleviate symptoms such as:
- Low energy
- Depression
- Anxiety
- Dry eyes, skin, and hair
- Loss of head hair 2
From the Research
Role of Dehydroepiandrosterone (DHEA) in Women
- DHEA has been considered a hormone that reduces the symptoms associated with aging, and its usefulness in premenopausal and postmenopausal women has received attention 3.
- The effectiveness of DHEA in premenopausal women remains unclear, while in postmenopausal women with coexisting estrogen deficiency, its use is controversial 3.
- DHEA supplementation is effective in women with adrenal insufficiency and chronically treated with exogenous glucocorticoids, postmenopausal women with low bone mineral density and/or osteoporosis, premenopausal women with sexual disorders and low libido, and in women with vulvovaginal atrophy due to menopause or genitourinary syndrome of menopause 3.
- DHEA may also be effective in postmenopausal women with hypoactive sexual disorders, infertile women with diminished ovarian reserve, women suffering from depression and anxiety, and women with obesity and insulin resistance 3.
Benefits of DHEA in Women
- DHEA improves physical and psychological well-being, muscle strength, and bone density, and reduces body fat and age-related skin atrophy in elderly women 4.
- DHEA modulates cardiovascular signaling pathways and exerts an anti-inflammatory, vasorelaxant, and anti-remodeling effect, which may be beneficial for women with cardiovascular disease 4.
- Local administration of DHEA shows benefit in vulvovaginal atrophy, improving sexual function and wellbeing in postmenopausal women 5, 6.
Risks and Limitations of DHEA Use in Women
- High physiologic or pharmacologic use of DHEA may cause androgenic and estrogenic side effects, which are of concern for long-term administration 5.
- The use of DHEA to improve induction of ovulation response in women with diminished ovarian reserve is not recommended 5.
- The potential value of oral DHEA therapy for postmenopausal women is called into question due to inconsistent results and limited sample size of available studies 6.